Friday August 21, 2015

Ed. Note: This guest article,
written by Perri Klass, M.D., was originally posted in the New York
Times on August 17, 2015. The original article can be viewed
here.

A little more than a year ago, the
American Academy of Pediatrics issued a policy statement saying that all pediatric
primary care should include literacy promotion, starting at
birth.

That means pediatricians taking care of
infants and toddlers should routinely be advising parents about how important it
is to read to even very young children. The policy statement, which
I wrote with Dr. Pamela C. High, included a review of the extensive
research on the links between growing up with books and reading
aloud, and later language development and school success.

But while we know that reading to a
young child is associated with good outcomes, there is only limited
understanding of what the mechanism might be. Two new studies
examine the unexpectedly complex interactions that happen when you
put a small child on your lap and open a picture book.

This month, the journal Pediatrics published a study that used
functional magnetic resonance imaging to study brain activity in
3-to 5-year-old children as they listened to age-appropriate
stories. The researchers found differences in brain activation
according to how much the children had been read to at home.

Children whose parents reported more
reading at home and more books in the home showed significantly
greater activation of brain areas in a region of the left
hemisphere called the parietal-temporal-occipital association
cortex. This brain area is "a watershed region, all about
multisensory integration, integrating sound and then visual
stimulation," said the lead author, Dr. John S. Hutton, a clinical
research fellow at Cincinnati Children's Hospital Medical
Center.

This region of the brain is known to be
very active when older children read to themselves, but Dr. Hutton
notes that it also lights up when younger children are hearing
stories. What was especially novel was that children who were
exposed to more books and home reading showed significantly more
activity in the areas of the brain that process visual association,
even though the child was in the scanner just listening to a story
and could not see any pictures.

"When kids are hearing stories, they're
imagining in their mind's eye when they hear the story," said Dr.
Hutton. "For example, 'The frog jumped over the log.' I've seen a
frog before, I've seen a log before, what does that look like?"

The different levels of brain
activation, he said, suggest that children who have more practice
in developing those visual images, as they look at picture books
and listen to stories, may develop skills that will help them make
images and stories out of words later on.

"It helps them understand what things
look like, and may help them transition to books without pictures,"
he said. "It will help them later be better readers because they've
developed that part of the brain that helps them see what is going
on in the story."

Dr. Hutton speculated that the book may
also be stimulating creativity in a way that cartoons and other
screen-related entertainments may not.

"When we show them a video of a story,
do we short circuit that process a little?" he asked. "Are we
taking that job away from them? They're not having to imagine the
story; it's just being fed to them."

We know that it is important that young
children hear language, and that they need to hear it from people, not from screens.
Unfortunately, there are serious disparities in how much language
children hear - most famously demonstrated in a Kansas study that
found poor children heard millions fewer words by age 3.

But it turns out that reading to - and
with - young children may amplify the language they hear more than
just talking. In August,Psychological Science reported on
researchers who studied the language content of picture books. They
put together a selection from teacher recommendations, Amazon best
sellers, and other books that parents are likely to be reading at
bedtime.

In comparing the language in books to
the language used by parents talking to their children, the
researchers found that the picture books contained more "unique
word types."

"Books contain a more diverse set of
words than child-directed speech," said the lead author, Jessica
Montag, an assistant research psychologist at the University of
California, Riverside. "This would suggest that children who are
being read to by caregivers are hearing vocabulary words that kids
who are not being read to are probably not hearing."

So reading picture books with young
children may mean that they hear more words, while at the same
time, their brains practice creating the images associated with
those words - and with the more complex sentences and rhymes that
make up even simple stories.

I have spent a great deal of my career
working with Reach Out and
Read, which works through medical providers to encourage
parents to enjoy books with their infants, toddlers and
preschoolers. This year, our 5,600 program sites will give away 6.8
million books (including many to children in poverty), along with
guidance to more than 4.5 million children and their parents. (The
group also provided some support to Dr. Hutton's research.)

Studies
of Reach Out and Read show that participating parents read
more and children's preschool vocabularies improve when parents
read more. But even as someone who is already one of the choir, I
am fascinated by the ways that new research is teasing out the
complexity and the underlying mechanisms of something which can
seem easy, natural and, well, simple. When we bring books and
reading into checkups, we help parents interact with their children
and help children learn.

"I think that we've learned that early
reading is more than just a nice thing to do with kids," Dr. Hutton
said. "It really does have a very important role to play in
building brain networks that will serve children long-term as they
transition from verbal to reading."

And as every parent who has read a
bedtime story knows, this is all happening in the context of
face-time, of skin-to-skin contact, of the hard-to-quantify but
essential mix of security and comfort and ritual. It's what makes
toddlers demand the same story over and over again, and it's the
reason parents tear up (especially those of us with adult children)
when we occasionally happen across a long-ago bedtime book.

Thursday May 7, 2015

When we look back on our childhood,
many of us have fond memories of being read to, of snuggling up and
enjoying a favorite story with the people who love us. And it's not
so much the story that we remember, but the feeling of love and
security that it gave us. My father sat and cuddled my brother, my
sister and me every evening when he came home from work. We would
sit all together on the bed in our PJs, and he would read us a
story, or, if we were really lucky, make up one of his own. My
favorite was about a cabbage that uprooted itself and went on a
journey to become king of the vegetables!

It turns out that what has been a
time-honored tradition in so many families is actually a wonderful
way of helping children to reach their full potential. We now know
that when parents spend time focusing on their young children, it
stimulates their brains to create connections that last a lifetime.
Reading aloud gives children important early literacy skills and a
love of reading. More importantly, the act of enjoying time
together as a family creates the bonds that will give children a
foundation for future learning and for building loving
relationships.

At Reach Out and Read, we believe
that all families should have the tools and information needed to
make reading aloud a daily routine. There are many parents who want
to do the best for their children but don't know that the simple
act of reading aloud to their infants and toddlers every day can
make a world of difference.

Our Reach Out and Read doctors and
nurses have unparalleled access to families with young children at
a time when many are not given any other formal advice about
parenting. They give a new book to each child at their pediatric
check-ups, and guidance about the importance of reading
together.

It is a privilege to be able to
help families create their own memories of reading aloud together.
A Reach Out and Read doctor in Saucier, MS, told us this story:

"I know that Reach Out and
Read makes a difference to my patients. When I give my patients
their first book at the 6 month old well-child visit, I am often
told this is the only book in the home. The simple gift of one book
opens a door of possibility in the minds of the child's parents.
For the first time they consider the value of books in the home
life of their child. They usually come back at the next well-child
visit saying they have acquired a few other books for the child
that he enjoys sharing with his parents."

Monday April 20, 2015

The official definition of a book
is "a collection of printed pages bound inside a cover", but we all
know that a book is so much more than that. A book can have many
different meanings, depending on whose hands are holding it. For
some, it is an escape from the humdrum of everyday life, for some,
a journey into worlds they would not otherwise experience, and for
others, a source of valuable information, ideas and opinions that
enrich their lives.

The books that Reach Out and Read doctors and nurses give to a
young child at their well-child visit are more than the story
inside! They are a tool used to encourage parents to read
aloud regularly to their young children, a means of improving early
literacy skills in the communities they serve, a way of leveling
the playing fields.

Mounting evidence shows that what
happens in infancy and toddlerhood sets the stage for achievement
later in life. Improving literacy skills during a child's
first five years, a critical period of brain development, is an
effective way of helping all children to enter school with the
foundations for success at school and life beyond.

The Reach Out and Read program
builds on the unique relationship between parents and medical
providers to develop early reading skills in children. At each
well-child visit, our doctors and nurses give their young patients
a new book to take home, along with age-appropriate guidance to
parents about the importance of reading aloud to their infants and
toddlers.

In many cases, the book given at a
well-child visit is the first book the family has ever owned, and
becomes a much-treasured story. One doctor told us:

"We care for many low-income families, and I love bringing
a book in for a toddler and watching the parents' reaction to the
child's face lighting up when he or she receives the book. By 18
months of age, it's so obvious that the children have been read to
on a consistent basis."

By the time a child enters
kindergarten, they have a home library of at least 10 books, and
parents who read aloud to them to make these books come alive.

Friday April 17, 2015

Reach Out and Read
has recently embarked on an exciting joint initiative with Save the
Children to support and foster children's education and wellbeing
in some of the United States' most impoverished and isolated
regions. Funded by a $4.2 million federal grant from the Department
of Education's Innovative Approaches to Literacy Program, the
Building Child-Centered Communities in Rural America project uses a
collective approach to develop and improve literacy skills for
children from birth through 10 years old. The two-year program will
focus on 30 isolated communities in four states, South Carolina,
Kentucky, Colorado and Arizona, where access to quality early
learning opportunities is often the most difficult.

There is an
ever-growing achievement gap in America that starts in early
childhood. It is well established that children who are unable to
read on grade-level by the fourth grade are unlikely to ever catch
up, and in rural areas, where resources are few and far between,
nearly half of school children fail to meet this benchmark. The
best way to improve the chances for lifelong success is to reach
children in the first five years of life, a critical time period
when 90% of all brain development occurs. The interventions in
early childhood can then be reinforced through school-age
programs.

The
Building Child-Centered Communities in Rural America
project is grounded on the core premise that collaboration between
organizations results in a collective impact that is essential for
effecting lasting change. It will surround children in an
integrated structure of home, school, and community resources,
aligning a continuum of services from birth through 10 years
old.

Reach Out and Read medical
providers in the 30 communities participating in this project will
reach over 16,000 children from birth through five yearsof age.
They will give a new, developmentally-appropriate book to infants
and toddlers at each well-child visit, along with advice to parents
about the benefits of reading aloud to their children every day.
Research has shown that parents who have been given this advice by
their pediatrician or family physician read to their children more
often, and their children's language scores are improved. This is
an important intervention in communities where many children are
not enrolled in early education programs.

To reinforce this message, every
family participating in Save the Children's home visitation
program, Early Steps to School Success, will receive high-quality,
age-appropriate children's books to ensure that each family is able
to build their own library and help their children develop a love
of reading.

Save the Children already provides
additional support for these children as they reach school through
donations of $4,000 to $6,000 worth of books for school-age
programming. This project will allow for the additional provision
of:

$10,000 worth of books, tablets and e-books for each
school

Afterschool literacy, physical activity and nutrition
programs

Parent-child events

Training and technical assistance.

As the final piece in this
multi-faceted project, a Community Literacy Manager will be hired
locally to increase community collaboration in this far-reaching
project, and to build local capacity and leadership for deeper
impact and sustainability.

Supporting early childhood literacy
education through the interacting approaches supported by this
grant will have far-reaching outcomes:

Communities that have the capacity
to support early child literacy

Families that are connected to
schools, libraries and community organizations

Parents and caregivers that have
the knowledge and skills to support their children's
development